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medical claims examiner: Resume Samples & Writing Guide
Employment history
Jr. Medical Claims Examiner, Walmart Bentonville, Arkansas
July 2022 – April 2023
- Review medical claims for accuracy and completeness
- Prepare reports and documents related to claims processing
- Analyze medical records and other documentation to determine coverage and benefit eligibility
Education
University of Texas, Austin, Texas
Doctor of Human Resources Management, May, 2022
University of Texas, Austin, Texas
Bachelor of Science in Medical Office Administration, May, 2018
Skills
Interpersonal
Adaptability
Documentation
Social Media
Coding
Microsoft Excel
Multi-tasking
Claims Processing
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Professional Summary
Highly experienced Medical Claims Examiner with a strong attention to detail and excellent organizational skills. Proven ability to efficiently process and review medical claims while ensuring accuracy and compliance with established regulations.
Employment history
Lead Medical Claims Examiner, JPMorgan Chase New York, New York
June 2011 – Present
- Maintain current knowledge of changes in the healthcare industry
- Maintain records of claims activity
- Process claims according to established guidelines
Medical Claims Examiner, Amazon Seattle, Washington
June 2010 – May 2011
- Identify potential fraud and abuse
- Prepare and submit appeals for denied claims
- Contact providers and other third parties to obtain information
Junior Medical Claims Examiner, CVS Health Woonsocket, Rhode Island
November 2009 – May 2010
- Verify insurance coverage and eligibility
- Resolve discrepancies and investigate complex issues
- Ensure compliance with applicable laws and regulations
Education
University of Maryland, College Park, Maryland
Master of Arts in Human Resources Management, September, 2009
University of Maryland, College Park, Maryland
Bachelor of Arts in Business Administration, September, 2005
Skills
Flexibility
Accounting
Communication
Public Speaking
Interpersonal Communication
Insurance Verification
Claims Processing
Time Management
Professional Summary
Highly organized and detail-oriented Medical Claims Examiner with extensive experience in the administrative and clerical field. Skilled in accurately and efficiently processing medical claims with a focus on compliance and customer service.
Employment history
Senior Medical Claims Examiner, Google Mountain View, California
April 2012 – Present
- Analyze medical records and other documentation to determine coverage and benefit eligibility
- Identify potential fraud and abuse
- Reconcile claims and payments
Associate Medical Claims Examiner, General Electric Boston, Massachusetts
April 2011 – March 2012
- Identify potential fraud and abuse
- Ensure compliance with applicable laws and regulations
- Contact providers and other third parties to obtain information
Junior Medical Claims Examiner, Bank of America Charlotte, North Carolina
September 2010 – March 2011
- Process claims according to established guidelines
- Maintain records of claims activity
- Ensure compliance with applicable laws and regulations
Education
Stanford University, Stanford, California
Master of Arts in Office Administration, August, 2010
Stanford University, Stanford, California
Bachelor of Arts in Medical Office Administration, August, 2006
Skills
Communication
Professionalism
Interpersonal
Risk Management
Medical Records
Insurance Claims
Microsoft Office
Insurance Verification
Professional Summary
Highly organized and detail-oriented Medical Claims Examiner with expertise in administrative and clerical tasks. Proven track record of accurately scrutinizing and processing medical claims with a strong commitment to customer service.
Employment history
Senior Medical Claims Examiner, Walmart Bentonville, Arkansas
July 2009 – Present
- Respond to customer inquiries regarding claims
- Process claims according to established guidelines
- Reconcile claims and payments
Associate Medical Claims Examiner, Walmart Bentonville, Arkansas
January 2009 – June 2009
- Ensure compliance with applicable laws and regulations
- Verify insurance coverage and eligibility
- Resolve discrepancies and investigate complex issues
Junior Medical Claims Examiner, Microsoft Redmond, Washington
January 2008 – December 2008
- Reconcile claims and payments
- Maintain records of claims activity
- Review medical claims for accuracy and completeness
Education
Cornell University, Ithaca, New York
Bachelor of Science in Medical Office Administration, November, 2007
Skills
Mentoring
Documentation
Supervisory
Emotional Intelligence
Coding
Data Entry
Customer Service
Filing
Employment history
Senior Medical Claims Examiner, Amazon Seattle, Washington
December 2020 – Present
- Ensure compliance with applicable laws and regulations
- Prepare and submit appeals for denied claims
- Analyze medical records and other documentation to determine coverage and benefit eligibility
Medical Claims Examiner, Bank of America Charlotte, North Carolina
June 2020 – November 2020
- Analyze medical records and other documentation to determine coverage and benefit eligibility
- Contact providers and other third parties to obtain information
- Maintain records of claims activity
Junior Medical Claims Examiner, Apple Cupertino, California
June 2019 – May 2020
- Maintain records of claims activity
- Prepare and submit appeals for denied claims
- Respond to customer inquiries regarding claims
Education
University of Michigan, Ann Arbor, Michigan
Office Administration, April, 2019
Skills
Social Media
Problem Solving
Technical
Conflict Resolution
10-Key
Microsoft Office
Multi-tasking
Medical Terminology
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medical claims examiner Job Skills
For an medical claims examiner position, your job skills are a key factor in demonstrating your value to the company and showing recruiters that you're the ight fit for the role. It's important to be specific when highlighting your skills and ensure that they are directly aligned with the job requirements, as this can greatly improve your chances of being hired. By showcasing your relevant skills and experience, you can make a compelling case for why you're the best candidate for the job.
How to include technical skills in your resume:
Technical skills are a set of specialized abilities and knowledge required to perform a particular job
effectively. Some examples of technical skills are data analysis, project management, software proficiency,
and programming languages, to name a few.
Add the technical skills that will get hired in your career
field with our simple-to-use resume builder. Select your desired resume template, once you reach the skills
section of the builder, manually write in the skill or simply click on "Add more skills". This will
automatically generate the best skills for your career field, choose your skill level, and hit "Save &
Next."
- Data Entry
- Medical Terminology
- Coding
- Medical Billing
- Claims Processing
- HIPAA Compliance
- Typing
- Insurance Verification
- Data Analysis
- Microsoft Office
- Medical Records
- Filing
- Insurance Claims
- Microsoft Excel
- Interpersonal Communication
- Customer Service
- Multi-tasking
- 10-Key
- Problem Solving
- Time Management
How to include soft skills in your resume:
Soft skills are non-technical skills that relate to how you work and that can be used in any job. Including
soft skills such as time management, creative thinking, teamwork, and conflict resolution demonstrate your
problem-solving abilities and show that you navigate challenges and changes in the workplace
efficiently.
Add competitive soft skills to make your resume stand-out to recruiters! Simply select
your preferred resume template in the skills section, enter the skills manually or use the "Add more skills"
option. Our resume builder will generate the most relevant soft skills for your career path. Choose your
proficiency level for each skill, and then click "Save & Next" to proceed to the next section.
- Communication
- Interpersonal
- Leadership
- Time Management
- Problem Solving
- Decision Making
- Critical Thinking
- Creativity
- Adaptability
- Teamwork
- Organization
- Planning
- Public Speaking
- Negotiation
- Conflict Resolution
- Research
- Analytical
- Attention to Detail
- Self-Motivation
- Stress Management
- Collaboration
- Coaching
- Mentoring
- Listening
- Networking
- Strategic Thinking
- Negotiation
- Emotional Intelligence
- Adaptability
- Flexibility
- Reliability
- Professionalism
- Computer Literacy
- Technical
- Data Analysis
- Project Management
- Customer Service
- Presentation
- Written Communication
- Social Media
- Troubleshooting
- Quality Assurance
- Collaboration
- Supervisory
- Risk Management
- Database Management
- Training
- Innovation
- Documentation
- Accounting
- Financial Management
- Visualization
- Reporting
- Business Acumen
- Process Improvement
- Documentation
- Relationship Management.
How to Improve Your medical claims examiner Resume
Navigating resume pitfalls can mean the difference between landing an interview or not. Missing job descriptions or unexplained work history gaps can cause recruiters to hesitate. Let's not even talk about the impact of bad grammar, and forgetting your contact info could leave your potential employer hanging. Aim to be comprehensive, concise, and accurate.
Employment history
Lead Medical Claims Examiner, Bank of America Charlotte, North Carolina
January 2019 – May 2022
- Analyze medical records and other documentation to determine coverage and benefit eligibility
- Respond to customer inquiries regarding claims
- Contact providers and other third parties to obtain information
Associate Medical Claims Examiner, CVS Health Woonsocket, Rhode Island
July 2018 – December 2018
- Review medical claims for accuracy and completeness
- Ensure compliance with applicable laws and regulations
- Prepare and submit appeals for denied claims
Junior Medical Claims Examiner, Google Mountain View, California
July 2017 – June 2018
Education
Cornell University, Ithaca, New York
Master of Science in Accounting, May, 2017
Cornell University, Ithaca, New York
Bachelor of Science in Human Resources Management, May, 2013
Skills
Organization
Self-Motivation
Process Improvement
Documentation
Microsoft Excel
Insurance Verification
Filing
Multi-tasking
Unexplained Year Gaps and Missing Job Experiences are a No-no
Gaps in your resume can prevent recruiters from hiring you if you don't explain them.
Key Insights- It's okay to have gaps in your work experience but always offer a valid explanation instead of just hiding it.
- Use the gap to talk about positive attributes or additional skills you've learned.
- Be honest and straightforward about the gap and explain it using a professional summary.
How to Optimize Your medical claims examiner Resume
Keep an eye out for these resume traps. Neglecting to detail your job roles or explain gaps in your career can lead to unnecessary doubts. Grammar blunders can reflect negatively on you, and without contact information, how can employers reach you? Be meticulous and complete.
Virginia Watson 852 Pinecrest Avenue, River Edge, NJ 07661
Employment history
Entry Level Medical Claims Examiner, CVS Health Woonsocket, Rhode Island
March 2022 – December 2022
- Resolves discrepencies and investigates complex issues
- Responds to customers inquiries regarding claims
- Ensures compliance with applicable laws and regulations.
Education
Cornell University, Ithaca, New York
Bachelor of Arts in Medical Office Administration, January, 2022
Skills
Financial Management
Documentation
Planning
Coaching
Microsoft Office
HIPAA Compliance
Interpersonal Communication
Time Management
Avoid Spelling Mistakes and Include your Contact Information
Missing contact information prevents recruiters from understanding you're the best fit for the position.
Key Insights- Make sure you're not missing contact information on your resume. That should include your full name, telephone number and email address.
- Make sure to use a professional email address as part of your contact information.
- Highlight your contact information and double check that everything is accurate to help recruiters get in touch with you.
medical claims examiner Cover Letter Example
A cover letter can be a valuable addition to your job application when applying for an medical claims examiner position. Cover letters provide a concise summary of your qualifications, skills, and experience, also it also gives you an opportunity to explain why you're the best fit for the job. Crafting a cover letter that showcases your relevant experience and enthusiasm for the Accounts Payable role can significantly improve your chances of securing an interview.
Associate Medical Claims Examiner
Google
Mountain View, California
Mountain View, California
Greetings Google Hiring Team
I am a results-driven Medical Claims Examiner with 1 years of experience in Administrative & Clerical. I am excited to submit my application for the Associate Medical Claims Examiner role at Google, where I believe I can make a valuable contribution to your team.
Throughout my life, I have pursued my passion for Data Entry and sought out opportunities to learn and grow. My experience in Administrative & Clerical has given me valuable skills such as Interpersonal and Adaptability that have allowed me to improve professionally and personally. I am excited to bring these skills and my passion as a Medical Claims Examiner to the position and work with a team of like-minded individuals to achieve our common goals.
Thank you for considering my application for the Associate Medical Claims Examiner position. With my skills and the amazing team at this organization, I am assured that I can contribute to your organization's success and make a meaningful impact. Looking forward to a future where we can work together.
Best regards,
Bernie Nelson
723-732-5504
[email protected]
Bernie Nelson
Showcase your most significant accomplishments and qualifications with this cover
letter.
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Build your Resume in 15 minutes
Give yourself the best chance of standing out from the
competition!
Create an awesome resume that meets the expectations of potential employers with our selection of professional, field-tested resume templates.
Create an awesome resume that meets the expectations of potential employers with our selection of professional, field-tested resume templates.